Thursday, November 5, 2009

Red Alert

I've had a hard time making sense of the latest news about health care legislation. In the Senate, Joe Lieberman seems to be backing off from his threat to filibuster a reform bill; maybe he realized that a filibuster isn't necessary because you can shut down the Senate by simply writing a letter.

Over in the House, the wacky extremists at the AARP are supporting the House health bill, but Republican congresswoman Virginia Foxx responds that health care reform is worse than terrorism. Apparently, either my grandmother is a card-carrying member of a terrorist organization, or Virginia Foxx is a raving lunatic. I'll see grandma in a couple weeks, so I'll let you know what I find out.

Sunday, October 18, 2009

Truth in Advertising?

If you've been following the news on TV lately you may have seen this ad for Blue Shield. (For those who can't or don't want to watch the video, here's a summary: A man's face appears in front of the word "happens" on the screen. The man speaks with a lisp and says "I lost my front tooth the other day, which would be great if I was 7. I'm 46. And the tooth fairy doesnt come when you're 46, just lots of referrals, and appointments, and bills that cost tons. Maybe I'll keep it. It adds character, right?" The Blue Shield logo then appears, and a voice-over says "We know life can be unpredictable, we offer affordable health coverage, and also dental plans. Choose Blue Shield today."

The ad reminds us of why insurance exists - to protect against unforeseen harms, like losing a tooth. We are led to believe that having Blue Shield insurance will take care of the hassle and expense of unexpected medical (and dental) problems.

All that makes sense. But is it true? Or is Blue Shield earning its initials here? We'll come back to that in a minute. Meanwhile...

Pop Quiz!

Imagine waking up and finding your shirt soaked in blood. You remove the shirt and find that blood is seeping from your nipple. What do you do?

A) go back to sleep and hope it stops bleeding by itself
B) seek medical care to find out why blood is coming out of your nipple and stop it
C) invite your kinky vampire friend over

Which of those choices would you consider reasonable under the circumstances? Think carefully because the answer might cost you.

Faced with this situation, Rosalinda Miran-Ramirez went to the Emergency Room at a nearby hospital. When it was time to pay the ER bill, her insurer (surprise: Blue Shield) refused to pay for the ER visit, saying that Miran-Ramirez "reasonably should have known that an emergency did not exist."

That kind of thinking puts Miran-Ramirez (and anyone else who has health insurance and might experience an unexpected medical condition) between a rock and a hard place. She can either err on the side of caution (and risk being stuck with a massive ER bill) or else wait (and risk that the problem will get worse because she didn't seek prompt medical attention).

I won't pretend that insurers like Blue Shield are entirely responsible for this situation. Of course, health care costs in general are too high and continue to rise. And the need to make up for unpaid bills is a big reason why emergency care in particular is so expensive. (Basically, people who don't have insurance use emergency services when they need medical care, and when they can't pay the bill, everyone else gets overcharged to balance things out). A public health insurance option would go a long way toward solving this problem, by creating access to scheduled, non-emergency care for those who are currently uninsured.

So perhaps it's a bit unfair to blame Blue Shield, when the problem is systematic. But I can't help thinking that Rosalinda Miran-Ramirez would be calling "BS" if she saw one of those commercials right now.

Thursday, October 15, 2009

Crunch Time

A few weeks ago, things looked pretty bleak for the public option. But the fight is not over.

House Speaker Nancy Pelosi confirmed today that she intends to push for a government-run health insurance program as part of health care reform package currently moving through Congress.

It's not going to be an easy fight. Although Maine Republican Olympia Snowe voted in favor of the Senate Finance Committee's health reform package, that proposal does not include a public option, and Snowe says she won't support a plan that does (though perhaps she should reconsider that position, considering that a strong majority of Maine voters support a public option).

At this point it looks like the best chance for a public option would involve a program administered by the states - Nebraska Senator Ben Nelson, who had not previously voiced support for a public option, said last week that he's open to a state-managed alternative.

Although he's not exactly the guy you want making headlines, and probably won't have much, if any, influence over his colleagues in the Senate, Illinois Senator Roland Burris is demanding a public option. You go, Roland.

Finally, an update on the big baby: Rocky Mountain Health Plans reversed course and said it will no longer categorically deny coverage for overweight infants. This is great news for the Lange family, but the rest of us are still stuck with a system where insurers can make arbitrary decisions to refuse coverage based on a pre-existing condition. Let's fix that: contact your senators to tell them we need a public option.

Monday, October 12, 2009

You can't make this stuff up

In case you were wondering how low the insurance companies are willing to go ... according to The Denver Post, an insurer called Rocky Mountain Health Plans recently refused to cover Alex Lange because of a pre-existing condition.

Now, you might be wondering why that's newsworthy. If you've been paying attention to the news lately (and I'll assume that if you're reading this blog, you're paying attention) you know that countless Americans are being denied insurance because of pre-existing conditions.

In this case you have to look a little closer. What is Alex Lange's pre-existing condition that makes him uninsurable? He's overweight - specifically, he's at the 99th percentile for weight among his age group. Now the kicker: Alex is 4 months old.
"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."
Alex Lange's story is a good example of why we need a public option: insurance companies will always favor the bottom line over doing what's right for society. Until we have a legitimate public option that forces private insurers to truly compete, they will have no reason to offer insurance to cute, chubby people like Alex Lange.

Friday, October 9, 2009

The Face

The reason I started this blog was seeing my friends, neighbors and relatives suffer without affordable, comprehensive health insurance -- but there's another reason, I think, that it seems like such a serious responsibility to me that we all cooperate to provide that insurance.

I experienced an incident in China about five years ago that has made the fight for a public option, and for real, affordable health care for all Americans seem critical, immediate, and crucial. China is controlled by its communist government, but their health care system is considerably more influenced by the free market even than ours in the United States, and (partially due to limited resources) they don't have guarantees we have such as the emergency room mandate, guaranteed basic health care for seniors, or care for the poor.

My partner and I were traveling in Dandong in northeast China, and were coming back to our hotel one night when we saw a couple on a motorcycle run over an older man on a bicycle who was making a left turn. It was dark, but not late, and there were about fifteen or so people on the street. She ran over to see if he was okay; I started trying to get passers-by or people working in shops to call an ambulance; the couple on the moped, who had been knocked off it, got up and fled.

I couldn't get anyone to place the call, or even to lend me their phone so that I could make the call in my half-broken Chinese. Who will pay for it, they said? We'll be responsible if we call an ambulance. They'll trace my phone. I can't call from my business, because they'll fire me for putting them at risk.

I was essentially having a health insurance policy debate. They can't make you pay, I said, they'll pay. Who is they, they said. Everybody pays, I said. The city keeps the hospital open. The city will pay. The city won't pay.

Sadly, they were right and I was wrong -- there was no system in place to help this man, and no community support to help those watching him do the right thing.

What I didn't have to do -- what too few of us who are having this debate ever do -- is what my partner did: stay with the man lying there waiting in the street, his bike twisted underneath him, ribbons of his face hanging from his jaw, trying to breathe through the blood.

Waiting for his neighbors to make the call. Waiting for me. Running out of time to wait while we figured out who is responsible and what we should do.

It was one incident in an enormous city in an enormous country -- only fifteen people saw it start to finish -- but if you did see it, if you had stood there, helpless, waiting for nothing, it would be as clear to you as it is to me. The health of our brothers, sisters, mothers, fathers and children is our responsibility. When a man dies who could have lived, it diminishes us all. We can shirk our responsibility -- can get up in Congress and say that we don't have the money or we don't like the government -- but we can't escape it. 44,000 Americans will die this year because they lack health insurance. You and I may not have seen it happen, but it is happening, and until we take responsibility for ourselves, our communities, and our nation, it will continue to happen.

We're the people on the roadside: we look away from the suffering around us, because we feel helpless to do anything about it. But we're not helpless. Public option legislation is our best chance to provide real protections and real care to people at affordable prices. We are so close -- today, with just a few Senate votes between us and the change that we need -- we have come so far from the days when disinformation (death panels! socialism!) and apathy dominated the debate. We can keep up the pressure -- increase it -- and we can have a strong, national public option. But it will not be given to us; we have got to take it.

The injured, the sick, and the suffering wait for you and for me; they've waited for years. What are you going to do? Who is responsible?

Thursday, October 8, 2009

brb Asia

Got some news for you -- while the debate in Congress drags on, and incredible organizations like Health Care for America Now, Sick for Profit, Rock the Vote, Physicians for a National Health Program as well as millions of committed individuals fight for sane, effective, humane, and efficient American health care, my job's taking me out of the country for the next few months, and I won't be able to post here or respond to comments.

I was never really supposed to be doing this: my regular bit basically involves reading, language, and travel. I started this blog out of a kind of sense of compulsion, and have been trying to run it in my spare time (which should be obvious to anyone who reads every day -- some pretty thin entries, back there in the archives...).

If all goes well, I won't be back before our Congress votes on, and Barack Obama signs, a strong public option. One that gives the government the power to negotiate for lower health care costs, and one in which any American can choose to participate.

Until then, this blog will slow down a great deal -- I'm going to put the comments on moderation to avoid dozens of ads for Cialis cluttering up the place, and hopefully Mattlo In His Infinite Wisdom will have plenty to say (although he's got a full time job too, so you know), but there may be a good bit more silence in the next few weeks.

As long as I'm doing a meta-what-about-the-blog post, here are blog-related facts: since I started monitoring traffic on September 12, a little under a month ago, the blog has had 712 page views and 403 unique visitors. The most linked-to post was "Specifically, Women", which got picked up by feminist blog Feministing. The most commonly viewed individual page was GradMed Insurance Review, thanks to our OCD, underutilized friends at GradMed aka American Insurance Administrators aka all sorts of things. The blog has been accessed from Britain, Singapore, Turkey, Japan, and Spain. Someone from Vilnus, Lithuania arrived here last week by doing a Google blogsearch for "bill +method" (I don't think they were looking for info on the Baucus bill, but that's what they got).

My favorite picture on the blog is this one, a real circular from the early 60s outlining the treasonous Communist sympathies of John F. Kennedy. The cutest person on the blog is this person. My favorite reader comment is this one, which outlines what an AIDS patient had to do in order to get his life-saving medication covered by Pacificare. His success -- and his willingness to fight -- gives me hope that the rest of us can win our fight against the insurance industry, too.

Also, Dying for a Public Option is the only Internet site in the entire world which contains the phrase "internet fancyparties". This phrase, wholly invented by me personally, is not a registered trademark and may be freely used for any and all purposes.

I have one more post ready for tomorrow, but after that, I'm out. I sort of had fun doing this. If we end up with affordable health insurance for all Americans, I will have really had fun doing this. Thank you all for the outgoing links to HCAN and the calls to Congress. Please keep up the good work.

Tuesday, October 6, 2009

Republicans for Reform

A quick rundown of the surprisingly numerous and influential Republican supporters of comprehensive, cost-saving health insurance reform. I'd assumed Republicans were a solid front on this because I was focusing on Senate Republicans: the party at large is not quite so partisan, or quite so monolithic. They're listed by name (with a link to their statement of support), position, and secret superpower.

Arnold Schwarzenegger, governor of California, can dual-wield shotguns;

Michael Bloomberg, mayor of New York City, poops money;

Shepard Smith, Fox News commentator, able to fit his whole fist in his mouth;

Bill Frist, former Senate majority leader and medical doctor, secretly repairs railway trestles;

Bill O' Reilly, Fox News host, world's third hardest blower;

Bob Dole, presidential candidate and former senator, can bench press a VW microbus.


Now, this is more complicated than it looks -- Bill Frist said straight out that he'd vote for the Baucus bill, then sort of walked back from it -- Shep Smith basically just made an impassioned argument for the public option on TV (he said "every vote against the public option is a vote for the insurance companies"), and then contradicted himself later, as is the nature of his show -- but Bloomberg and Schwarzenegger both cited the Obama administration's plan by name in official press releases, and Bill O'Reilly was quite explicit about favoring the public option in particular, and the reasons he cited -- that it will keep insurance costs down for working Americans -- were identical to those you'd find here.

Even admitting, though, that the views of these conservatives are varied and occasionally tentative, this is not what the picture looked like in August. The public option and other forms of wide-ranging health insurance reform are no longer poorly understood, fringe ideas -- they're something the nation has clearly grown more comfortable with, and more able to analyze in practical terms (what saves money? What insures the most people) rather than emotional terms (who is a Commie? Who is killing my grandmawmaw?).

Here's hoping that this collection of elected officials, elder statesmen, and political commentators finds some kind of voice among the Senate Republicans, and opens the way for a practical bill to be passed -- one with provisions to insure everyone and keep costs down.